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General NPI Number Information
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NPI Number | 1396938858
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Entity Type | Organization
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Legal Business Name | STEPHEN L MATNEY PC
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Dates
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Enumeration Date | 08/19/2007
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Last Update Date | 05/08/2017
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Provider Practice Location Address
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Address Line | 629 S MILLER ST
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City | SHELBYVILLE
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State | IN
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Zip | 46176-1931
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Country | US
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Telephone | 317-733-9904
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Fax | 317-733-9956
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Provider Business Mailing Address
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Address Line | 629 S MILLER ST
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City | SHELBYVILLE
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State | IN
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Zip | 46176-1931
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Country | US
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Telephone | 317-733-9904
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Fax | 317-733-9956
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Authorized Official
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Title or Position | OWNER
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Name | MR. STEPHEN L MATNEY
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Credential | MD
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Telephone | 317-733-9904
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 01036908
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License Number State | IN
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